Ghofrani Hossein A, Wilkins Martin W, Rich Stuart
Department of Internal Medicine, Medical Clinic II/V, University Hospital Giessen and Marburg GmbH, Klinikstrasse 36, 35392 Giessen, Germany.
Circulation. 2008 Sep 9;118(11):1195-201. doi: 10.1161/CIRCULATIONAHA.106.674002.
The availability of new treatments for patients with pulmonary arterial hypertension has increased awareness and interest in the medical community for pulmonary vascular diseases in general. Many uncertainties exist, however, regarding the diagnosis and treatment of patients with pulmonary arterial hypertension that are particularly pertinent for the management of patients with idiopathic pulmonary arterial hypertension and pulmonary hypertension associated with underlying diseases. This review highlights controversial issues around the definition and diagnosis of pulmonary hypertension, the interpretation of hemodynamic variables, and the interpretation of clinical responsiveness to chronic therapies. In addition, we propose guidelines applicable to the conduct of new therapeutic trials in pulmonary arterial hypertension, which aim to provide greater confidence in the efficacy and safety of new treatments currently under development.
肺动脉高压患者新治疗方法的出现，提高了整个医学界对一般肺血管疾病的认识和兴趣。然而，对于肺动脉高压患者的诊断和治疗仍存在许多不确定性，这些不确定性对于特发性肺动脉高压和与基础疾病相关的肺动脉高压患者的管理尤为重要。本综述重点介绍了围绕肺动脉高压的定义和诊断、血流动力学变量的解释以及对慢性治疗的临床反应性的解释等有争议的问题。此外，我们提出了适用于开展肺动脉高压新治疗试验的指南，旨在增强对目前正在研发的新治疗方法的疗效和安全性的信心。
